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Abstract Background Inguinal herniation of the urinary bladder is uncommon and those descending into the scrotum are even rarer. Although open anterior repair has been used for inguinal bladder hernia, the efficacy of laparoscopic herniorrhaphy has been reported in recent years. Case presentation A 63-year-old man presented with an irreducible right groin and scrotal bulge associated with voiding difficulty. Abdominal ultrasonography showed a dislocation of the urinary bladder descending into the right scrotum. Abdominal CT imaging revealed that a part of the bladder and small intestine was herniating into the scrotum through the internal inguinal ring and running laterally to the inferior epigastric artery. Under the diagnosis of indirect inguinal bladder hernia, the patient underwent trans-abdominal preperitoneal hernia repair (TAPP). The bladder herniated into the scrotum through the internal inguinal ring was replaced to the original position. Then the myopectineal orifice was exposed and covered with polypropylene mesh, where a horizontal peritoneal incision 4 cm above the hernia orifice, i.e., the high peritoneal incision approach (HPIA), allowed an easy peeling of the peritoneum and hernia sac. The patient’s postoperative course was uneventful and the voiding difficulty resolved. The patient continued to do well without recurrence at 20 months after surgery. Conclusion Preoperative evaluation with abdominal ultrasonography and CT scan allowed a precise diagnosis of a groin hernia with voiding difficulty. TAPP with HPIA was useful in the treatment of inguinal bladder hernia because this technique facilitated a quick confirmation of the hernia contents, secure dissection of the whole protruded bladder, and adequate replacement of the bladder to the original position without any injury.

Background: Inguinal herniation of the urinary bladder is uncommon and those descending into the scrotum are even rarer. Although open anterior repair has been used for inguinal bladder hernia, the efficacy of laparoscopic herniorrhaphy has been reported in recent years. Case presentation: A 63-year-old man presented with an irreducible right groin and scrotal bulge associated with voiding difficulty. Abdominal ultrasonography showed a dislocation of the urinary bladder descending into the right scrotum. Abdominal CT imaging revealed that a part of the bladder and small intestine was herniating into the scrotum through the internal inguinal ring and running laterally to the inferior epigastric artery. Under the diagnosis of indirect inguinal bladder hernia, the patient underwent trans-abdominal preperitoneal hernia repair (TAPP). The bladder herniated into the scrotum through the internal inguinal ring was replaced to the original position. Then the myopectineal orifice was exposed and covered with polypropylene mesh, where a horizontal peritoneal incision 4 cm above the hernia orifice, i.e., the high peritoneal incision approach (HPIA), allowed an easy peeling of the peritoneum and hernia sac. The patient's postoperative course was uneventful and the voiding difficulty resolved. The patient continued to do well without recurrence at 20 months after surgery. Conclusion: Preoperative evaluation with abdominal ultrasonography and CT scan allowed a precise diagnosis of a groin hernia with voiding difficulty. TAPP with HPIA was useful in the treatment of inguinal bladder hernia because this technique facilitated a quick confirmation of the hernia contents, secure dissection of the whole protruded bladder, and adequate replacement of the bladder to the original position without any injury. [ABSTRACT FROM AUTHOR]

Background: The rate of bladder injury during inguinal hernia repair in children is not well known. However, it is known that bladder injury during childhood inguinal hernia repair places a serious morbidity burden on children. We sought to determine an algorithm to avoid accidental bladder injuries. Methods: Reports that included pediatric patients with inguinal hernias containing the bladder were searched. Keywords and mesh term searches were conducted in the MEDLINE, Scopus, and Web of Science databases. We reviewed our clinical records and found that two patients had inguinal hernias containing the bladder. Results: Nineteen articles reporting on 26 patients diagnosed with the presence of the bladder within the inguinal canal from 1962 to 2021 were included in this article. Our two patients were added to this group. Diagnoses were made incidentally during genitourinary radiological examinations (n = 3), intraoperatively during hernia repair (n = 7), or due to clinical symptoms and findings (n = 18) after standard hernia repair. Bladder augmentation was required for three patients. Conclusions: During the operation, if there is any suspicion regarding the presence of the bladder in the inguinal region, we suggest performing a preoperative cystogram to confirm the position of the bladder and its injury. We recommend that the sac should be opened and the contents inspected before performing transfixion during high ligation of the hernia sac. [ABSTRACT FROM AUTHOR]

Inguinal bladder hernia is a very rare clinical form, representing 1–4% of inguinal hernias. More than 90% of cases are discovered intraoperatively, with iatrogenic bladder injury occurring in 16% of cases. We report the case of a 67-year-old patient with a history of left inguinal hernia, who presented with a strangulated inguinoscrotal hernia with a tense bursa, painful spontaneously and irreducible to palpation. The abdominopelvic CT scan revealed a giant inguinoscrotal bladder hernia. The bladder resection for a necrosis portion was indicated. This case presents interesting considerations and potential pitfalls when evaluating a patient with an inguinal hernia.

An 88-year-old man had previously undergone surgical repair for bilateral inguinal hernias and a left femoral hernia. He visited our emergency unit complaining of right inguinal distension and voiding disturbance. Blood tests showed acute renal failure and Radiographic imaging showed bilateral hydronephrosis associated with protrusion of the intestine and bladder into the inguinal region. We considered the cause to be a recurrence of the right inguinal hernia, resulting in acute postrenal failure. Manual replacement was performed to reduce the bulge, with disappearance of voiding disturbance. Surgical repair was scheduled for a later date. Preoperative ureteral stenting was requested, and bilateral ureteral stenting was attempted. Right ureteral stenting was impossible because it was difficult to identify the ureteral orifice due to severe bladder deformity. Accordingly, we created a right percutaneous nephrostomy, followed by anterograde, thereby achieving ureteral stenting. Radical hernia repair operation was performed later, and the clinical condition proved to be a femoral hernia. Postoperative cystoscopy showed only lateral displacement of the right ureteral orifice, and the bilateral ureteral stents were removed at this point. Imaging after removal of the ureteral stents showed improvement in the position of the urinary tract and bladder, and disappearance of the hydronephrosis. The next day the right nephrostomy catheter was removed. We herein report a case of bladder hernia with hydronephrosis requiring bilateral ureteral stenting due to acute postrenal failure, with some discussion of research papers. [ABSTRACT FROM AUTHOR]

Introduction: Although inguinal hernia is common in the general population, the bladder involvement within the hernial sac is rare, and its incidence varies between 0.5 and 3 %. The aim of this study is to report a case of inguinoscrotal hernia with bladder content and to review the relevant literature. Case report: A 69-year-old male patient was clinically assessed for a left inguinoscrotal mass and spontaneous urination of the intra-abdominal portion of the bladder with the need for manual suprapubic pressure of the hernia and scrotal elevation to complete the bladder emptying (Mery’s sign). Surgery revealed a direct Gilbert type IV inguinal fl oor defect, with a signifi cant bladder segment protrusion across the fl oor of the inguinal canal. The defect was successfully repaired in a conventional way with a Lichtenstein technique employing heavy polypropylene mesh. Conclusion: A rare entity that generally constitutes an intraoperative fi nding when we do not have previous imaging studies, and that is resolved with a conventional hernioplasty using prosthetic material. [ABSTRACT FROM AUTHOR]

A 73 y/o male with first presentation of urinary retention from two months ago referred to our department by an urologist for prostate cancer staging. The patient had gleason score of 5+4 and total PSA of 79. He underwent [99mTc]Tc-MDP and [99mTc]Tc-HYNIC-PSMA scans on two different days. The bone study revealed diffuse uptake in sacrum and a focus of abnormal [99mTc]Tc-MDP activity in the right SI joint. Another focus was also noted in right pubic region best seen on anterior projection which later on SPECT/CT was confined to a bladder diverticulum with tracer accumulation protruding into the right inguinal canal forming a hernial sac. Following a few days, [99mTc]Tc-HYNIC-PSMA scan was carried out and depicted high uptake in sacrum and right pubic region as well. The uptake was again localized to the bladder hernia on dedicated SPECT/CT acquisition. The findings denotes an important differential diagnosis of the pubic metastases as well as added value of SPECT/CT imaging in aforementioned scans. [ABSTRACT FROM AUTHOR]

Bladder herniation with obstructive uropathy is a relatively rare occurrence, however, urinary bladder herniation along with ureteroneocystostomy and leading to positional obstructive uropathy of the graft is an unusual presentation. This is a unique case of a 38-year-old male who presented with inguinal hernia with raised serum creatinine who had undergone renal transplant 10 years back in 2011. Magnetic resonance urogram revealed herniation of urinary bladder and hydroureteronephrosis of transplant kidney. Patient is managed by surgical exploration through inguinal incision and reduction of ureteroneocystostomy herniation after ureterolysis and hernioplasty was performed. The cause of obstructive uropathy was herniation of the bladder along with ureteroneocystostomy, and the patient has an insidious onset of symptoms, immediate exploration, and repair of hernia done without any need for percutaneous nephrostomy. Importance of this case report is that sliding herniation of the bladder with ureteroneocystostomy should be considered a diagnosis and investigated if the patient presents with positional obstructive uropathy with inguinal hernia, leading to early identification and salvaging the graft function.

Abstract Inguinal hernia may contain the bladder as one of its contents, while bilateral inguinal bladder herniation is rare. Urinary obstruction and obesity are associated with increased abdominal pressure and are risk factors of bladder herniation. Clinicians should be aware of the bladder hernia in elderly with chronic dysuria and obesity.

Background: The rate of bladder injury during inguinal hernia repair in children is not well known. However, it is known that bladder injury during childhood inguinal hernia repair places a serious morbidity burden on children. We sought to determine an algorithm to avoid accidental bladder injuries. Methods: Reports that included pediatric patients with inguinal hernias containing the bladder were searched. Keywords and mesh term searches were conducted in the MEDLINE, Scopus, and Web of Science databases. We reviewed our clinical records and found that two patients had inguinal hernias containing the bladder. Results: Nineteen articles reporting on 26 patients diagnosed with the presence of the bladder within the inguinal canal from 1962 to 2021 were included in this article. Our two patients were added to this group. Diagnoses were made incidentally during genitourinary radiological examinations (n = 3), intraoperatively during hernia repair (n = 7), or due to clinical symptoms and findings (n = 18) after standard hernia repair. Bladder augmentation was required for three patients. Conclusions: During the operation, if there is any suspicion regarding the presence of the bladder in the inguinal region, we suggest performing a preoperative cystogram to confirm the position of the bladder and its injury. We recommend that the sac should be opened and the contents inspected before performing transfixion during high ligation of the hernia sac.

Inguinoscrotal herniation of the bladder is an uncommon condition. Clinicians should have a high index of suspicion for involvement of the bladder within a hernia when the lower urinary tract urinary symptoms are concurrently present in patients presenting with a painful groin lump. We report the case of a patient who presented with an inguinoscrotal hernia involving the urinary bladder, which was irreducible due to the fact that the herniated portion of the bladder contains multiple containing calculi. The patient underwent successful operative repair of the hernia and had an uncomplicated post-operative course. Key takeaway messages for clinicians are that the presence of lower urinary tract symptoms in a patient concurrently presenting with a groin lump should raise suspicion of bladder involvement within the hernia and that pre-operative imaging is valuable to identify the contents of the hernia to allow safe operative planning and to reduce the risk of bladder injury during surgery. [ABSTRACT FROM AUTHOR]

Introduction: Bladder hernia is relatively rare in cases of inguinal hernia. In some instances, bladder hernia may be treated as inguinal hernia if bladder prolapse is not recognized. Because of the rarity of inguinal bladder hernias, there are no related detailed reports from studies performed at a single institution. In our hospital, patients with suspected inguinal hernia undergo CT in the prone position, enabling the diagnosis of bladder hernia preoperatively. This study aimed to clarify the clinical characteristics of inguinal bladder hernias and consider noteworthy points in their laparoscopic treatment. Methods: This retrospective analysis included data from 32 consecutive patients with bladder hernia in 1126 patients with inguinal hernia. In each patient, the lengths of the hernial orifice and prolapsed bladder were measured on the CT images and intraoperatively. Totally extraperitoneal (TEP) repair was performed in all patients, who were then followed for 1 year postoperatively. Results: Inguinal bladder hernia was detected on CT in 32 of 1126 patients (2.8%). Among them, only five (15.6%) had urological symptoms such as pollakiuria or the sensation of residual urine. The 32 patients were classified into three groups according to hernia subtype: intraperitoneal (n = 12, 37.5%), para‐peritoneal (n = 15, 46.9%), and extraperitoneal (n = 5, 15.6%). The prolapsed bladder of the extraperitoneal type was significantly shorter than that of the other subtypes. The prolapsed bladders were directly identified in the extraperitoneal space and repaired safely with TEP. One recurrence (3.1%) occurred 2 months postoperatively. Conclusion: Preoperative CT and TEP are useful for the definitive diagnosis and treatment of inguinal bladder hernia. [ABSTRACT FROM AUTHOR]

Bladder herniation with obstructive uropathy is a relatively rare occurrence, however, urinary bladder herniation along with ureteroneocystostomy and leading to positional obstructive uropathy of the graft is an unusual presentation. This is a unique case of a 38‑year‑old male who presented with inguinal hernia with raised serum creatinine who had undergone renal transplant 10 years back in 2011. Magnetic resonance urogram revealed herniation of urinary bladder and hydroureteronephrosis of transplant kidney. Patient is managed by surgical exploration through inguinal incision and reduction of ureteroneocystostomy herniation after ureterolysis and hernioplasty was performed. The cause of obstructive uropathy was herniation of the bladder along with ureteroneocystostomy, and the patient has an insidious onset of symptoms, immediate exploration, and repair of hernia done without any need for percutaneous nephrostomy. Importance of this case report is that sliding herniation of the bladder with ureteroneocystostomy should be considered a diagnosis and investigated if the patient presents with positional obstructive uropathy with inguinal hernia, leading to early identification and salvaging the graft function. [ABSTRACT FROM AUTHOR]

This article discusses the rare medical condition of bladder hernia, which affects a small percentage of individuals, primarily men between the ages of 50 and 70. Bladder hernia can cause a range of symptoms, from mild irritation to severe kidney failure. It is often diagnosed during surgery as it can remain asymptomatic. Common complications include urinary tract infections, urinary calculi, and the rare occurrence of bladder tumors. Treatment involves surgical intervention to repair the hernia and reposition the bladder. The article presents a case study of a 61-year-old patient who underwent successful surgical repair of a bladder hernia. [Extracted from the article]

Inguinal bladder hernia is a rare clinical condition, and only a small number of reported cases have been treated by laparoscopic surgery. We report a case of a patient aged 65-year-old who presented to our outpatient care unit for a right inguinal swelling. Computer tomography (CT) imaging showed a direct inguinal hernia with bladder and epiploic content. We performed a laparoscopic transabdominal preperitoneal repair, which involved carefully reducing the bladder's protrusion from the hernial orifice. Subsequently, a mesh prosthesis was employed to treat the right inguinal hernia. This case represents an unusual instance of a successful laparoscopic repair for a right direct inguinal bladder hernia., Competing Interests: The authors declare no competing interests., (Copyright: Ghassane El Omri et al.)

Inguinal hernias involving the bladder are exceedingly rare and pose a diagnostic challenge. Identifying bladder involvement within an inguinal hernia is imperative to avoid iatrogenic bladder injuries and subsequent complications. Here we discuss a case of inguinal bladder herniation and bladder visualization using methylene blue dye intraoperatively. We present a case of a 45-year-old male who presented with a six-hour history of dysuria and a painful non-reducible right-sided groin mass that had previously been reducible for 17 years. Computed tomography demonstrated an irreducible indirect inguinal hernia-containing bladder. Open Lichtenstein repair was performed, and intraoperative methylene blue-dyed saline successfully identified the herniated bladder, preventing iatrogenic bladder injury. This case report demonstrates the importance of preoperative imaging and intraoperative visualization for the prevention of complications in a rare occurrence of a strangulated indirect inguinal hernia-containing bladder., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Gerard et al.)

Inguinal hernia is frequent and reaches up to 8% of the population. It was reported that over 20 million inguinal hernia repairs are performed annually. The bladder may herniate in 1%–3% of the cases through the inguinal canal that can be responsible for various symptoms. The most specific is the classic “two-stage micturition.” However, the diagnosis usually remains unspecific, and a surgeon can fall in the trap of a “simple” inguinal hernia and cause accidental damages to an undiagnosed bladder hernia. Therefore, a clear diagnosis must be assessed based on clinical and radiological findings to avoid complications. In these two presented cases, the patients presented cystolithiasis complicating the bladder herniation. One of the patients also developed a bladder tumor which appeared to be urothelial carcinoma.

• Inguinal bladder hernia (IBH) is a rare condition that is difficult to diagnose preoperatively. • 16% of IBHs are diagnosed postoperatively due to bladder injury and leakage. • Preoperative diagnosis of IBHs is important to lessen postoperative complications. • Transabdominal preperitoneal approach can significantly reduce the risk of bladder damage. Inguinal bladder hernia (IBH) is a rare condition that is difficult to diagnose preoperatively based only on physical examination; 16% of IBHs are diagnosed postoperatively due to complications. We report the case of a 56-year-old man who presented with left inguinal swelling and increased frequency of urination since eight years. Physical examination demonstrated a 6 × 4 cm non-reducible left inguinal bulge with mild tenderness on palpation. Computed tomography revealed a left inguinal hernia containing a portion of the urinary bladder. He was diagnosed with IBH and transabdominal preperitoneal (TAPP) repair was performed. We confirmed a left internal inguinal hernia and incised the peritoneum from the outside of the left inguinal ring. The preperitoneal space was dissected toward the Retzius space, and the prolapsed bladder was examined. The adhesion with the surroundings was carefully dissected and the bladder was reduced into the abdomen. Indigo carmine was injected through a urinary catheter, which confirmed that no bladder damage had occurred. After the mesh was positioned to cover the myopectineal orifice, it was fixed to the Cooper's ligaments, interior side, lateral side, and ventral side. The postoperative course was uneventful, and the patient is now free of symptoms and recurrence two months after surgery. TAPP repair is a useful treatment for IBH. Preoperative diagnosis of IBH is important to lessen postoperative complications. [ABSTRACT FROM AUTHOR]

Purpose: Bladder hernias are asymptomatic in most cases and are found incidentally during exploration for inguinal hernia repair. The treatment of inguinal bladder hernia is either reduction or resection of the herniated bladder, followed by herniorrhaphy. We present a case series with preoperative diagnoses, along with their surgical outcomes.Methods: We retrospectively reviewed the medical records from a single institution over a 5-year period (2012-2017) of five patients with diagnosis of large bladder inguinal hernia. Demographics, clinical status, medical history, anatomical structure of the hernia, and surgical outcomes were all analyzed.Results: Patients' median age was 51 years (range 45-81 years). The median size of the hernial sac was 13 cm (range 8-20 cm). The diagnosis was made with computed tomography in three patients and with ultrasonography and cystography in two patients. Median length of hospital stay was 2 days (range 1-6 days), and median length of follow-up was 28 months (range 18-72 months). All patients continue to be alive and well, without hernia recurrence. The five cases are described separately along with their surgical managements.Conclusion: The main objectives in treatment of inguinal bladder hernia are to preserve the voiding function and to avoid bladder injuries in a tension-free hernia repair. To our knowledge, this is the first series of cases in which all inguinal bladder hernias were diagnosed preoperatively. [ABSTRACT FROM AUTHOR]

Herniation of the urinary bladder is observed in around 1%–4% of cases. Bladder herniation rarely presents with obstructive uropathy; however, bladder herniation carrying ureteroneocystostomy and leading to obstructive uropathy of the graft is even rare. Here, we present a case of a 36-year-old male with deranged renal function test who had undergone renal transplant 10 years back. Computed tomography scan revealed bladder herniation with ureteroneocystostomy and hydronephrosis. He was surgically explored by Gibson incision and ureterolysis, and hernioplasty was performed. Although the cause of herniation was ureteroneocystostomy, it was managed immediately without any need for percutaneous nephrostomy.

• Inguinal bladder hernia is an unusual condition that requires a high index of clinical suspicion for diagnosis. • This case demonstrates the importance of preoperative diagnosis in avoiding surgical complications including bladder injury. Cases of inguinal bladder hernia are rare, with bladder involvement seen in 1–4% of inguinal hernias. The majority of cases are diagnosed intraoperatively, with only 7% of bladder hernias identified prior to surgery. Diagnosis may be challenging as patients are often asymptomatic or have nonspecific symptoms. Surgical repair is currently the standard treatment, and careful surgical planning is necessary to avoid complications including bladder injury. A 58-year-old man presented to our Emergency Department with 2-day history of progressively worsening left lower quadrant pain, groin bulge, and dysuria. Physical exam revealed an irreducible left inguinal hernia associated with urinary urgency on attempted reduction. Plain CT was ordered and demonstrated inguinal hernia with bladder protrusion into the left scrotum. The patient underwent open surgical reduction and hernia repair and made a quick postoperative recovery without complications. Inguinal bladder hernia most often presents in older, obese males and clinicians should have a high index of suspicion when assessing patients with inguinal hernia. Preoperative diagnosis based on history, physical, and radiologic imaging allow for careful surgical planning and prevention of severe complications including bladder injury and leakage. We present a case report of inguinal bladder hernia in a middle-aged man that presented as left lower quadrant pain, groin pain, and dysuria. Diagnosis was confirmed preoperatively with radiographic imaging. The hernia was surgically reduced and the defect repaired without complications. [ABSTRACT FROM AUTHOR]

A 70-year-old man was referred to the Urology Service of our University Hospital for an irregular thickening of the left anterior–lateral urinary bladder wall found in a computed tomography scan following gross haematuria. In particular, the computed tomography scan showed irregularity of the mucosal aspect and an irregular thickening of the bladder wall in close proximity of an inguinal hernia. The computed tomography exam also showed an unusual little fatty seizure in the parietal planes. A magnetic resonance imaging confirmed the thickening in the same area as the hernia with a mainly extraluminal presentation and extension in the perivesical adipose tissue. Cystoscopy did not show alteration of the mucosal surface. Urine cytology showed normal urothelium cells. At the time of the left inguinal hernia repair, the bladder was isolated from the inguinal hernia fat tissue and then opened with median cystotomy. Biopsy of the anterior–lateral bladder wall showed normal urothelium and an abundant component of mature lobules of adipose tissue in the sub-epithelial connective tissue extending among the muscle bundles of muscularis propria, compatible with a diagnosis of lipomatosis, a very rare lesion in the urinary bladder. [ABSTRACT FROM AUTHOR]

Bladder hernias usually begin asymptomatically and are discovered incidentally at the time of discovery. Preoperative diagnosis of bladder hernias is important to reduce the risk of bladder injury during surgery. Although F-18 FDG PET/CT is applied for oncological purposes, benign conditions should also be taken into account when evaluating the implants. In this article, a case of bladder hernia, which can be confused with pathological cancer involvement, with the diagnosis of F-18 FDG PET/CT performed in a 73-year-old male patient with renal cell carcinoma is presented. [ABSTRACT FROM AUTHOR]

The retractile organ is a term generally used for testis. It refers to the displacement of the organ over time in a specific route along the inguinal canal. The condition that we encounter in our case is similar. Hence, we define this event as a retractile bladder. The inguinal canal becomes a flabby pouch because of the weakening of its walls. The bladder moves within the inguinal canal without strangulation. The purpose of our paper draws attention to this situation. Herein, we present a case of an 84-year-old patient with a left inguinal retractile bladder hernia accompanied by computed tomography and ultrasonography findings. [ABSTRACT FROM AUTHOR]

Inguinal hernia may contain the bladder as one of its contents, while bilateral inguinal bladder herniation is rare. Urinary obstruction and obesity are associated with increased abdominal pressure and are risk factors of bladder herniation. Clinicians should be aware of the bladder hernia in elderly with chronic dysuria and obesity. Clinicians should be aware of the bladder hernia in elderly with chronic dysuria and obesity. [ABSTRACT FROM AUTHOR]

Background: Inguinal hernia repair is the most common surgical procedure in babies. Despite a meticulous technique, relapses may occur. The occurrence of a direct bladder wall hernia in relapses has never before been reported in the literature.Case Presentation: Here, we report two cases of direct bladder herniation: a white baby boy born after 25 weeks of gestation and a white baby boy born after 26 weeks of gestation. Both of the formerly extremely low birth weight babies were affected after open bilateral hernia repair. Recurrent hernias developed on the right side, and direct bladder herniation was identified intraoperatively. In one case, laparoscopy was applied to identify a supravesical type of hernia. Immaturity and a difficult postnatal course might have contributed to hernia relapse in these cases.Conclusions: Misinterpretation of bladder herniation might have disastrous consequences. Laparoscopy is a helpful tool in comparable cases. [ABSTRACT FROM AUTHOR]

Inguinal hernia is frequent and reaches up to 8% of the population. It was reported that over 20 million inguinal hernia repairs are performed annually. The bladder may herniate in 1%–3% of the cases through the inguinal canal that can be responsible for various symptoms. The most specific is the classic "two-stage micturition." However, the diagnosis usually remains unspecific, and a surgeon can fall in the trap of a "simple" inguinal hernia and cause accidental damages to an undiagnosed bladder hernia. Therefore, a clear diagnosis must be assessed based on clinical and radiological findings to avoid complications. In these two presented cases, the patients presented cystolithiasis complicating the bladder herniation. One of the patients also developed a bladder tumor which appeared to be urothelial carcinoma. [ABSTRACT FROM AUTHOR]

The hernia content involving a bladder segment occurs in 1-4 % of cases of the inguinal hernias. Inguinoscrotal bladder hernias are usually found incidentally on radiological examinations or at the time of herniorrhaphy. We present an adult case that has a left inguinal bladder hernia detected and evaluated by sonography, intravenous pyelography (IVP), and computerized tomography (CT). [Arch Clin Exp Surg 2014; 3(3.000): 187-189]

Hernia through a defect of the broad ligament is extremely rare in children. These defects can result from a developmental defect or a spontaneous rupture of cystic formations remnants of mesonephric ducts or Müller. Genital anomalies associated with unilateral renal agenesis are more common in females. We report the case of a 13 months girl allowed for assessment of recurrent urinary tract infection; abdominal examination did not objectified palpable mass, the external genitalia were without abnormalities. Abdominal ultrasound revealed a left renal space is empty with a retrovesical cyst. Cystography was requested that objectified a large pelvic cystic mass retrovesical communicating with the bladder, there was also a left vesicoureteral reflux. Uro- MRI showed a cystic formation retrovesical communicating with the bladder, the right pelvic kidney; uterus is normal size for age. DMSA scintigraphy confirmed the absence of the left kidney with the right kidney that ensures 100 % of total renal function. To surgical exploration we found a hernia of the bladder through the left broad ligament, the uterus was dislocated on the right side; left ovary was hypoplasic; the ipsilateral ureter was blind with renal agenesis, we performed by reduction of the bladder then closing the hernial orifice, dissection of the ureter with its ligation and section at the vesical stoma. The postoperative course was uneventful. Evolution is favorable. This observation illustrates a hernia of the bladder through the broad ligament associated with ovarian hypoplasia, renal agenesis and ipsilateral ureter blind ending; this association was not described to our knowledge in the literature.